Gut Liver.
2015 Sep;9(5):607-614. 10.5009/gnl14135.
A Proton Pump Inhibitor's Effect on Bone Metabolism Mediated by Osteoclast Action in Old Age: A Prospective Randomized Study
- Affiliations
-
- 1Division of Gastroenterology, Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea.
- 2Division of Endocrinology, Department of Internal Medicine, Eulji General Hospital, Eulji University School of Medicine, Seoul, Korea. kimhj@eulji.ac.kr
- KMID: 2234066
- DOI: http://doi.org/10.5009/gnl14135
Abstract
- BACKGROUND/AIMS
Proton pump inhibitors (PPIs) act by irreversibly binding to the H+-K+-ATPase of the proton pump in parietal cells and may possibly affect the vacuolar H+-ATPase in osteoclasts.
METHODS
We investigated the effect of 8 weeks of PPI treatment on the parameters of bone turnover and compared PPI with revaprazan, which acts by reversibly binding to H+-K+-ATPase in proton pumps. This study was a parallel randomized controlled trial. For 8 weeks, either a PPI or revaprazan was randomly assigned to patients with gastric ulcers. The parameters of bone turnover were measured at the beginning of and after the 8-week treatment period.
RESULTS
Twenty-six patients (PPI, n=13; revaprazan, n=13) completed the intention-to-treat analysis. After the 8-week treatment period, serum calcium and urine deoxypyridinoline (DPD) were increased in the PPI group (serum calcium, p=0.046; urine DPD, p=0.046) but not in the revaprazan group. According to multivariate linear regression analysis, age > or =60 years was an independent predictor for the changes in serum calcium and urine DPD.
CONCLUSIONS
In elderly patients, administering a PPI for 8 weeks altered bone parameters. Our study suggested that PPIs might directly alter bone metabolism via the vacuolar H+-ATPase in osteoclasts.
Keyword
MeSH Terms
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Aged
Amino Acids/drug effects/urine
Bone Remodeling/*drug effects
Bone and Bones/*metabolism
Calcium/blood
Female
Humans
Intention to Treat Analysis
Linear Models
Male
Middle Aged
Multivariate Analysis
Osteoclasts/*metabolism
Prospective Studies
Proton Pump Inhibitors/*pharmacology
Pyrimidinones/*pharmacology
Tetrahydroisoquinolines/*pharmacology
Amino Acids
Calcium
Proton Pump Inhibitors
Pyrimidinones
Tetrahydroisoquinolines
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